Fatigue, Burnout, Resilience – Why am I feeling this way?

Listen to the recording of this session presented by Michelle O’Rourke

By Michelle O’Rourke

Living and working through the pandemic has affected us deeply, and often we can’t quite put our finger on why we are not feeling like we used to.  For the most part, this ‘heaviness’ we feel at times is an accumulation of stressors and challenges, with a myriad of causes, including:

  • Grief and loss – the loss of life as we knew it, and the losses of those we loved and cared for
  • Worry/anxiety – with many unknowns including if/when we will return to ‘normal’
  • Frustration/anger – loss of control over how we move, work and live our lives
  • Continuous change – new rules, lockdowns, decisions – made by others
  • Physical, emotional and mental exhaustion – with no downtime to recover and no reserve
  • Challenges of providing care during the pandemic – using PPE; fewer resources and the effects of visitor restrictions to name a few

Increasing our capacity for resilience can help us to cope as well as ‘bounce back’ from life’s challenges, supporting our health and wellbeing. Resilience can be strengthened with attention to self-care, an increased self-awareness, and decreasing some of our chronic stressors.  

I often hear people say that “I don’t have time to take care of myself, because I am too busy taking care of everyone else”.  If that is the case, it won’t be long before fatigue and burnout become an issue for you.  Self-care is not something we add on to our already full ‘to-do’ list.  It is an intentional way of living, where our values, attitudes and actions are integrated into our daily routines.  What is it that nourishes and refreshes you?  You are the only one who knows that – and you must be convinced that taking care of yourself is worthwhile and essential, because only you can do it for yourself! Paying attention to your whole self – body, mind and spirit – is part of this.  It doesn’t take ‘extra’ work, just an attention to how you are treating yourself, and doing what you need to stay healthy without feeling guilty. Some ideas include:

Body – am I eating healthy, going for a walk now and then, taking breaks and getting enough rest? 

Mind – looking at what is on my plate – since I probably always add more to it without taking anything off!  Don’t be afraid to prioritize, delegate and simplify responsibilities.  Find some quiet time everyday, and learn the words ‘no’ and ‘enough’. Engage in hobbies and activities you enjoy.

Spirit – enjoy nature and the arts; identify what refreshes you and build it in to your schedule; spend time with loved ones; find inspirational things to reflect on; practice gratitude; tend to your own spiritual needs and cultivate an inner life.  Basically, find out what feeds your heart and your soul and seek that out! 

Increasing self-awareness involves reflecting on the day; checking in with how you are doing inside and out, and exercising self-compassion.  We are often hard on ourselves, and it is important to keep our expectations realistic for the time we are living in.  Mindfulness is also key – trying to take a deep breath now and then to focus on the moment – not obsessing with how things used to be or what the future holds.  One day, one decision at a time. 

There is only one you!  You are no good to yourself, your loved ones or your clients if you crash and burn.  Make the commitment today, to take care of yourselves as you take care of others! 

A reflection by Maureen Russell

Today I met with a wonderful group of Health Care Assistant students from Capilano University. In preparation for the time together they sent me a list of questions, and I in turn considered the questions and what I might share. I shared with them a reflection written by Maureen Russell, a psychosocial care provider who lives and works in southern Ontario.
This reflection was inspired by a man whose experience with a Personal Support Worker helped him to trust, to open up, and prepared him to eventually be able to meet with Maureen in the last weeks of his life. Maureen was adamant, that without the work of the PSW the man never would have been able to open up with her and address some of the deeper issues that he carried.

Reflection—Undressed 

You entered, and my heart sank. Today would be the first day I would allow a stranger to bathe my broken body. 

How could I have come to this…this moment of unwanted dependency? 

I cringe with despair. A tear dares to sneak its way from beneath the mask of courage I so sheepishly hide behind. 

Who are you, Stranger? Who are you they send to enter my intimate space? 

Do you know ME? Do you know who I am? 

How do I let go into your hands, that which has only been felt by the gentleness of my mother’s touch oh so long ago? 

I shudder as you draw near. My decrepit body tenses and my stomach churns. I close my eyes and turn away, anticipating your cold and callous touch. 

I wait…I wait… 

Till broken is the air by your slow and soft voice…“This must be difficult for you. How can we best do this together?” 

How     can       we       best     do        this            together?  you asked…. 

Breath releases, body relaxes and my facade of courage slips.  Tears flow. I let go. And the waltz begins… 

In the weeks and months to come, we danced every day as you cleaned and cared for my declining body with the utmost respect and compassion. 

Within this place of “the intimate” that I so desperately feared had morphed a space of trust. I felt safe to wonder aloud with you…“How will I die?” “Have I mattered?” “How will I be remembered?” “What is the purpose of it all?”  

You quietly listened without judgement or a need to fix…For that, I thank you.  

And then, you offered me another partner, a counsellor, who could take these new steps and dance the dance of purpose and meaning with me. And because of you, I could accept her help.

I could let go of my masks and facades and bare my true self on my last waltz. 

Little did I know when you entered that being undressed would allow me to be naked.  

Deep gratitude to YOU who cared for my body and gave space for my spirit.   

Contributed by Maureen Russell 

Thank you Maureen for sharing this wonderful reflection with us!

PSWs* identify their top five concerns

In July 2021 we invited PSWs (HCAs/CCAs) to identify their top five concerns. Their response:

  1. Preventing compassion fatigue and burnout.
  2. Dealing with grief associated with COVID, restrictions, etc..
  3. Finding education in palliative and end-of-life care education and training.
  4. Building the skills to be heard and acknowledged as vital members of the team.
  5. Working short staffed.

PSWs identify their top three reasons for engaging in education:

  • Learn the latest knowledge and best practices.
  • Improve skills to be a stronger member of the team.
  • Discover new tools and resources.

The PSW concerns and rationale for further education are supported by the recommendations from the July 2020, Ontario Ministry of Long Term Care report titled, “Staffing in Long Term Care”. This timely report highlighted the need to treat PSWs as full members of the team, and to provide education and increased leadership opportunities.

We are pleased to announce Palliative Care Education for PSWs, PACE for PSWs -this new online program is designed specifically for PSWs/HCAs/CCAs. This flexible online education, is a great opportunity for learning for PSWs and a wonderful way for teams to give thanks and support PSWs in their learning.

*PSWs – aka Health Care Assistants, Continuing Care Assistants, and refers to paid caregivers with other titles who do similar work.

A personal reflection on grief during the pandemic

Submitted by Kassey M. June 2021, reflecting on her grief while working in Long Term Care during COVID

Grief is an understandable reaction to loss. It’s the emotional pain you experience when something or someone you care about is taken away from you. It can be excruciatingly painful at times. From shock or fury to disbelief, remorse, and deep grief, I experience a wide range of uncomfortable and unexpected feelings. Grief is a total whole person experience, and may have a negative impact on physical health, making it difficult to sleep, eat, or even think clearly. These are common reactions to loss, and the greater the loss, the greater the grief. 

Personally, my most profound experience with grief was during my time working at a retirement home in the heart of the pandemic.

Personally, my most profound experience with grief was during my time working at a retirement home in the heart of the pandemic. I was approached right before our home was hit with its first case to come work at the front desk. I was warned that things would be more intense than the work I was doing previously, but I was up for the challenge. Immediately I was hit with a whole different perspective that I did not get to see working in dietary. Besides working with management and staff, I experienced constant losses as I cared for residents. 

I grew closest to the residents that had severe dementia on the second floor of the building. They loved my company and conversation. Making them smile and laugh brought them joy and allowed them to feel like they had loved ones around them. It made me feel attached and I would imagine caring for my own grandmother. Knowing that many of them did not have family visit, I felt proud that they remembered who I was and became excited when I arrived. Knowing this…was what really broke me when working through the pandemic.  

Our first deaths were those with severe dementia, then other residents who I had newly become acquainted with. Having to hear the news at almost every shift that someone else had passed and watching the residents deal with the loss of their friends and loved ones was difficult.  

There was no room to show any signs of emotion because they were so broken. Having to bottle these things in (still to this day) was debilitating. Having to speak to family members grieving over the deaths became numbing because again, you had to be strong. Knowing that there was nothing I could do to take away the pain from the residents and families made me feel almost like I was at fault. I could only offer my words and time to help them forget the world around them, even if for only a few moments.  

These feelings eventually caught up to me and I realized I was burned out. I was extremely emotional on some days, then snapped into feeling numb and emotionless. The grief felt like waves crashing down and flowing rapidly at all times. My emotions were about to burst and overflow at the drop of a hat. There were many moments at work that they did.  

I wish there was more help for staff who have to suffer through this grief. When I reached out for help there was nobody there to listen or allow me to process what was happening. Why? Maybe because we were all dealing with this and because we all felt like we were drowning. 

Grief doesn’t always get better with time; I am learning to function with it and it surprises me less often. I am forced to cope and adapt. It affects me in all aspects of my life. I have learned to seek help, and have learned how important mental health and selfcare is to cope with the grief. Recognizing and processing how I am feeling is the first step to getting better. 

Submitted by Kassey M

WEBINAR FOR PSWs  Addressing our Grief associated with COVID  

Register for September 1st, FREE WEBINARS FOR PSWs, Fatigue, Burnout and Resilience